The Rise of the New Health Monitoring Paradigm
Summary
- There has never been a greater desire to understand the key drivers for optimal health. Covid-19 continues to spur innovation. Terms such as biohackers and the quantified self have emerged, creating large new market opportunities.
- Remote Patient Monitoring (RPM) is rapidly moving beyond measuring standard vital signs, e.g., blood pressure, weight, temperature, and towards other biomarkers. Breakthroughs in technologies such as photonics will soon allow non-invasive and continuous monitoring of up to 100 different biomarkers at the same level of accuracy normally found with lab-grade devices.
- However, “just because you can measure something doesn’t mean you should.” Some critics point out there is no need to measure biomarkers such as glucose levels for people without diabetes (overdiagnosis versus body optimization). Yet, from our discussions with a variety of health companies and experts, it is clear that in the near future, commercially available devices with lab-grade quality will become table stakes in patient monitoring. This, in turn, will allow for better detection and prevention of several chronic diseases, all from the comfort of your home.
| “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” — WHO.
The pandemic has put a spotlight on personal health. In the past, people used to speak about their health only when they were ill. Today, almost everyone is looking for ways to improve both their physical and mental health. Covid-19 has spurred innovation, and it is fantastic to see the explosion of new developments in treatments and therapies for specific illnesses or conditions, such as breakthroughs in drug discovery (see our investment in CelerisTx) or the pace of progression of vaccines.
The consumerization of healthcare in particular, has gained a lot of momentum. Biohackers, those using science and technology to make their body function better and more efficiently, or the quantified self, knowledge through numbers, have become widely adopted terms. (Sideline: The Quantified Self is, in fact, a community of people interested in self-tracking tools — Tim Ferriss was among the attendees of the first Quantified Self meetup.)
One data point showing just how much consumers are pushing for personal health tech is the massive sale of smartwatches in recent years. It is estimated that 142m units were sold in 2021. These consumer-centric devices aim to make it easier for patients to navigate healthcare. Tracking our steps, monitoring our heart rate and sleep, and logging calories is becoming more ubiquitous. In this article, we have presented our thoughts on where we think the space of monitored consumer health is going in the future.
Mapping out the playing field
Often used during the recovery period, remote patient monitoring, or RPM, allows patients to measure their vital signs, blood pressure, weight, temperature, and more without visiting a doctor or hospital. As of 2021, the global market size for RPM devices was approximately $30b, growing at a CAGR of 18.9% in 2021–2028 (2).
Putting this number into perspective, the global wearable technology market was valued at $48b in 2021 and is expected to grow at a CAGR of 13.8% from 2021 to 2028 (3). The market’s value of wearable medical devices was estimated at $18b in 2021, growing at a CAGR of 15.8% from 2021 to 2026 (4).
Although RPM originally referred to the use of a specific technology facilitating the interaction between clinicians and patients at home, the monitoring of vital signs has developed in various directions. On the one hand, consumer wearables such as Fitbit and Garmin allow users to track data points, including heart rate and step count. On the other hand, the market of medical-grade specialized devices without a direct physician’s involvement is growing significantly.
We are now seeing a general trend in all RPM areas whereby technology enables more accurate and timely tracking. Companies such as Resilience (est. 2021 France, $51m raised to date), a software for early detection of cancer, enable direct communication between patients and physicians and offer a library of resources produced by health professionals. When it comes to CGM, arguably one of the areas of attention for RPM, the semi-invasive wearables FreeStyle Libre and Dexcom have for a long time been leading the way.
Companies, including DiaMonTech (est. 2015 Germany, $20m+ raised to date), are moving away from the invasive nature of CGMs to date and are using non-invasive photothermal detection to measure glucose levels. Beyond CGM, companies are trying to tackle other biomarkers. Out of the US, SiPhox (est. 2020 US, $9m raised to date) and Rockley Photonics (est. 2013 US, $500m raised to date) are leveraging photonics, the science and application of light, to measure lab-grade biomarker levels in the form of a handheld device or wearable.
Rockley has just announced a partnership with Medtronic: they plan to collaborate to bring Rockley’s recently announced Bioptx™ biomarker sensing platform into Medtronic’s solutions (5). A single wearable device could then monitor multiple biomarkers, including lactate, glucose, and body hydration.
The partnership with Medtronic builds on the societal shift from reactive to proactive healthcare. By potentially enabling round-the-clock, real-time, non-invasive monitoring of a person’s health and well-being, they empower clinicians and patients/users to personalize care with actionable data.
From invasive to non-invasive monitoring
RPM is clearly going in the direction of actioning towards health rather than monitoring existing illnesses. Drivers of the availability of quality care in non-hospital settings include:
- The rise in geriatric population;
- An increasing prevalence of chronic diseases;
- The growing adoption of AI.
However, we doubt that mass adoption of commercial health monitoring will see an uptake if patients have to continue to prick their fingers or wear a chip under their skin.
Taking the example of CGM, invasive and semi-invasive tools have, until now, dominated the market because of the ease of obtaining accurate measurements from the interstitial fluid (body fluid present in the lowermost skin layer). However, now developments in photonics are resulting in higher accuracy of non-invasive measurements. Low infra-red (LIR) photonics have been used to create transmitters and receivers for fiber-optic telecommunication or act in the security and safety sector. Now for life sciences, mid-infrared (MIR) photonics, in particular, has gained momentum by delivering real-time chemical sensing data of specific biomarkers. Quantune Technologies (est. 2019 Germany, €2.5, raised to date) for example is working at high speed on this technology. We think of MIR as Photonics 2.0
The apparent target group of RPM devices is people with chronic diseases such as diabetes, heart disease, and cancer. Beyond that, biohackers, athletes, and people at risk of developing a particular illness e.g., during pregnancy or due to a family’s medical history, may express high interest in at-home health monitoring. We are confident that the pool of users will expand as technology develops toward non-invasive solutions and as people want to understand in real-time what is happening inside their bodies.
However, not everyone is excited about this trend.
| “Just because you can measure something doesn’t mean you should” — W. Edwards Deming (US-American physicist)
An article from Harvard Health Publishing questions: “If you don’t have diabetes, should you monitor your blood sugar?” The author analyses whether there is any benefit for people without diabetes to monitor their blood sugar levels with CGMs. He posts that little published research would support this case (6).
However, what the HHP article probably did not fully consider is the increasing research in non-invasive biosensing. From a general consumer standpoint, mass adoption of biosensing devices, compared to smartwatches, is unlikely to occur right away. Questions remain around regulation, price points, and levels of accuracy.
From our discussions with a variety of health experts, it is clear that commercially available devices with lab-grade quality will not only become a reality. New business models will emerge that will ultimately leverage new datasets to deliver better health outcomes. This way, the target group will not only be biohackers or people at risk of illness, but prevention through connected care will become available for almost anyone. The consumerization of healthcare is in motion!
Until then, a more detailed conversation needs to take place around using these new sets of health data, both at a macro and micro level that will become available. Questions such as “How and who makes the best use of this novel type of consumer health data? What does it mean when my lactate levels are elevated? And when do I need to bring a physician in the loop?” will have to be explored.
We are excited about the integration of biosensing tech into our everyday devices, smartphones, or smartwatches. After all, who would not want to monitor their health and act proactively in an automated way to live a longer and more fulfilling life?
Sources
- Smartwatch Shipments Forecast Worldwide From 2016 to 2025. https://www.statista.com/statistics/878144/worldwide-smart-wristwear-shipments-forecast/
- Global Remote Patient Monitoring Devices Market Share. https://www.fortunebusinessinsights.https://www.fortunebusinessinsights.com/remote-patient-monitoring-devices-market-106328 // https://www.globenewswire.com/news-release/2022/02/08/2380648/0/en/Global-Remote-Patient-Monitoring-Devices-Market-Size-2022-2028-to-Reach-USD-101-02-Billion-at-a-CAGR-18-9.html
- Wearable Technology Market Size. https://www.grandviewresearch.com/industry-analysis/wearable-technology-market // https://www.industryarc.com/Research/Wearable-Technology-Market-Research-504119 // https://www.mordorintelligence.com/industry-reports/wearable-technology-market
- Global Wearable Medical Devices Market. https://www.globenewswire.com/news-release/2022/03/17/2405232/28124/en/Global-Wearable-Medical-Devices-Market-Report-2021-2022-2026-Innovations-in-Medical-Wearables-Rushes-on-Full-Steam-to-Sustain-Long-Term-Growth-in-the-Market.html // https://www.grandviewresearch.com/industry-analysis/wearable-medical-devices-market
- Rockley Photonics and Medtronic Collaborate to Deliver the Next Generation of Wearable Healthcare Monitoring Devices. March 2020.
- Harvard Health Publishing. Shmerling, Robert H. Is blood sugar monitoring without diabetes worthwhile? June 2021.
- UCSD Researchers Develop a Wearable Skin Patch Monitors Blood Pressure, Glucose Levels, and Other Biomarkers in Human Sweat. October 2021.
